DENTAL HEALTH ASSOCIATES, INC. DENTAL PROGRAM FOR PARTICIPATING MEMBERS OF UFCW UNION LOCAL 324 FOOD DIVISION

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2 DENTAL HEALTH ASSOCIATES, INC. DENTAL PROGRAM FOR PARTICIPATING MEMBERS OF UFCW UNION LOCAL 324 FOOD DIVISION Since 1974 the DHA dental benefit program has been available to UFCW members in the Los Angeles area to cover eligible members and their eligible dependents. UFCW 324 is now offering the program with a new list of dental providers in the South Los Angeles and Orange County areas. Local 324 insists on high quality dental care, convenient hours and locations, reasonable fees, a truly comprehensive benefit schedule and private dental offices. Dental Health Associates, Inc. has a proven track record and has earned praise from UFCW members. Sincerely and fraternally, United Food & Commercial Workers Union, Local 324 Greg Conger President Provided by UFCW-Union, Local Stanton Avenue Buena Park, California Telephone (714) OR (800) 244-UFCW Under the direction of Dental Health Associates, Inc Laurel Canyon Blvd., Suite 209 North Hollywood, CA Telephone (818)

3 TABLE OF CONTENTS FOOD/MEAT DIVISION GENERAL INFORMATION... PAGE 2-4 ACTIVES: PLAN A PLATINUM PLUS... PAGE 5 PLAN A PLATINUM & GOLD... PAGE 5 PLAN A SILVER... PAGE 5 PLAN B PLATINUM PLUS... PAGE 6 PLAN B PLATINUM & GOLD... PAGE 6 PLAN B SILVER... PAGE 6 RETIREES: RETIREES WHO ARE ENROLLED IN THE DENTAL PLAN... PAGE 7 DENTAL OFFICES... PAGE 9 SPECIALTY OFFICES...PAGE 12 UNION OFFICE LOCATIONS... BACK COVER For additional information telephone or write the Union or Dental Health Associates, Inc. UFCW-Local Stanton Avenue Buena Park, CA Telephone (714) Dental Health Associates, Inc Laurel Canyon Blvd., Suite 209 North Hollywood, CA Telephone (818)

4 GENERAL INFORMATION FOOD / MEAT DIVISION ALL PLANS YOUR UFCW LOCAL 324 DENTAL HEALTH PROGRAM Local 324 has been working with DHA since 1974 to provide quality dental care for eligible members and their families. This plan makes quality dental care available at significant savings to all eligible Local 324 members and their eligible dependents. WHERE ARE THE DENTAL OFFICES LOCATED? WHAT ARE THEIR HOURS? One of the great advantages of the plan is that service is being provided by private dentists of your choice. Each dentist participating in the plan has arranged office hours for the convenience of their patients. Locations of the participating dentists are listed in this brochure. Choose a dentist close to home or work - whichever is most convenient for you. CAN I BE SURE OF QUALITY DENTISTRY? The most important direction UFCW Local 324 gave Dental Health Associates, Inc. was to provide high quality dental care. All of the panel providers were visited personally by DHA representatives to ensure that they met our high standards. Only those offices who qualified were asked to become part of our program. DHA is very proud to have so many fine offices to serve the needs of Local 324 members. WHO IS ELIGIBLE? Local 324 Food and Meat division eligible members and their eligible dependents enrolled in the Indemnity Dental Plan. If you do not know which plan you qualify for you may call DHA directly, (or your local Union office) for this information before using the reference material in this brochure. 2

5 GENERAL INFORMATION FOOD / MEAT DIVISION ALL PLANS / CONTINUED WHAT WILL DENTAL SERVICES COST? The cost of dental services will be determined by the plan for which you are eligible provided you have not met your yearly maximum. Most frequently performed dental services have little or no co-payments when you use a participating provider. Each plan has separate deductibles and maximums. These are explained on the following pages. Additional patient co-payments may be required where the annual maximum has been reached. When seen by a DHA specialist such as an Endodontist, Periodontist, Pedodontist, or an Oral Surgeon, additional co-payments will be required. All co-payments, including deductibles, are due at the time of service. Additional patient co-payments may be required where the annual maximum has been reached. Each Food Division member has a deductible which is per calendar year and does not apply to routine preventive and diagnostic care (cleaning, examination and x-rays). Some offices may have chosen to waive all or part of your annual deductible. Please contact the dental office directly for deductible information. WHAT ABOUT EMERGENCY CARE? Your local participating dentist will provide you with a telephone number to use in case of dental emergencies. Relief from pain is available 24 hours a day, seven days a week. 3

6 GENERAL INFORMATION FOOD / MEAT DIVISION ALL PLANS / CONTINUED WHAT HAPPENS ON MY FIRST VISIT? Your first visit, or that of an eligible family member, may include the following: 1. Examination of teeth, gums and surrounding areas. 2. Any necessary x-rays to determine the condition of areas of your mouth not visible to the eye. 3. Diagnosis of the existing conditions in your mouth. You and the dentist will discuss his findings and work out a long-range treatment plan. HOW DO I SCHEDULE AN APPOINTMENT? Simply select a dentist from the panel list. Telephone the office and arrange an appointment. Please give the dental office the social security number of the union member when making your appointment. Verification of eligibility will be handled by the dental office. Dental forms are available through the dental office or the local union. If you need to cancel an appointment, be sure to call at least 24 hours in advance. 4

7 FOOD / MEAT DIVISION PLAN INFORMATION The following is a brief description of benefits for each plan as they apply specifically to participating dental offices. PLAN A PLATINUM PLUS, PLATINUM, AND GOLD PLANS* Annual Maximum Per Person... $ Annual Deductible Per Person... $50.00 Family Deductible Maximum... $ Routine dental procedures such as examinations, x- rays, and cleanings have no out-of-pocket cost to the eligible member. See page 8 of this brochure for a sample of the most frequently performed services. All co-payments, including deductibles, are due at the time of service. Additional patient co-payments may be required where the annual maximum has been reached. PLAN A SILVER PLAN** Annual Maximum Per Person... $ Annual Deductible Per Person... $50.00 Family Deductible Maximum... $ Routine dental procedures such as examinations, x- rays, and cleanings have no out-of-pocket cost to the eligible member. See page 8 of this brochure for a sample of the most frequently performed services. All co-payments, including deductibles, are due at the time of service. Additional patient co-payments may be required where the annual maximum has been reached. *(Any employee with 43 or more months of employment.) **(Any employee with less than 43 months of employment.) 5

8 FOOD / MEAT DIVISION PLAN INFORMATION PLAN B PLATINUM PLUS, PLATINUM AND GOLD PLANS* Annual Maximum Per Person... $ Annual Deductible Per Person... $50.00 Family Deductible Maximum... $ Routine dental procedures such as examinations, x- rays, and cleanings have no out-of-pocket cost to the eligible member. See page 8 of this brochure for a sample of the most frequently performed services. All co-payments, including deductibles, are due at the time of service. Additional patient co-payments may be required where the annual maximum has been reached. PLAN B SILVER PLAN** Annual Maximum Per Person... $ Annual Deductible Per Person... $50.00 Family Deductible Maximum... $ Routine dental procedures such as examinations, x- rays, and cleanings have no out-of-pocket cost to the eligible member. See page 8 of this brochure for a sample of the most frequently performed services. All co-payments, including deductibles, are due at the time of service. Additional patient co-payments may be required where the annual maximum has been reached. *(Any employee with 43 or more months of employment.) **(Any employee with less than 43 months of employment.) 6

9 FOOD / MEAT DIVISION PLAN INFORMATION RETIREES Food and Meat Retirees who are enrolled in the Indemnity Dental Plan through the UFCW Trust Fund, will also be eligible to participate in this dental program. Annual Maximum Per Person... $ Annual Deductible Per Person... $50.00 Family Deductible Maximum... $ Routine dental procedures such as examinations, x- rays, and cleanings have no out-of-pocket cost to the eligible member. See page 8 of this brochure for a sample of the most frequently performed services. All co-payments, including deductibles, are due at the time of service. Additional patient co-payments may be required where the annual maximum has been reached. 7

10 FOOD / MEAT DIVISION ALL PLANS SAMPLE SCHEDULE OF PATIENT CO-PAYMENTS Examination...No Co-pay Full Mouth X-rays...No Co-pay Teeth Cleaning (1 in 6 Months)...No Co-pay Fluoride Treatment (Under 19)...No Co-pay White Fillings (Front Teeth Only)...No Co-pay Amalgam Fillings...No Co-pay Extractions (Simple)...No Co-pay Root Canals (Front Teeth)...No Co-pay Gum Treatment (Deep Cleaning)...No Co-pay Crowns (Porcelain & Metal)...No Co-pay* Crowns (Full Cast Metal)...No Co-pay* Dentures (Full or Partial)... $10.00 Denture Relines (Lab or Office)... $10.00 The above co-payments are for services provided by a DHA general dentist. Yearly deductibles may apply. Additional patient co-payments may be required where the annual maximum has been reached. When seen by a DHA specialist such as an Endodontist, Periodontist, Pedodontist, or an Oral Surgeon, additional co-payments will be required. General anesthesia may not be covered and should be preauthorized. *Additional charge may apply for precious or semiprecious metals. 8

11 DHA PANEL PROVIDERS General Dentists UFCW Union Local 324 Aliso Viejo All Smile Dental Group Pacific Park Dr. #A Phone: (949) Aliso Viejo Richard Wheatfill, DDS Pacific Park Dr. #106 Phone: (949) Anaheim Seven Day Dental 2265 W. Lincoln Ave. Phone: (714) Anaheim Huy Cao Nguyen, DDS 101 E. Lincoln Ave. #105 Phone: (714) Brea Brea Dental Group 503 E. Imperial Hwy. Phone: (714) Brea Kalvin Chen, DDS 903 S. Brea Blvd. Phone: (714) Corona Mitul Amin, DDS 828 W. 6th Street Phone: (951) Corona Dobson & Nguyen, DMD 720 Magnolia Ave. #A3 Phone: (951) Costa Mesa Lance Hamilton, DDS 234 E. 17th Street #107 Phone: (949) Costa Mesa Newport Dental Group 1835 Newport Blvd. #E-267 Phone: (949) Covina Walter Rong, DDS 236 W. Badillo Street Phone: (626) Dana Point Ocean Ranch Dentistry Golden Lantern #D Phone: (949) Downey Fred Bina, DDS S. Paramount Blvd. Phone: (562) Downey Gallatin Dental Group Paramount Blvd. #B Phone: (562) Fullerton Todd A. Baker, DDS 501 N. Cornell Avenue Phone: (714) Garden Grove Springtime Dental 9871 Chapman Avenue Phone: (714)

12 DHA PANEL PROVIDERS General Dentists Hacienda Heights Jennifer Chang, DDS 1850 S. Azusa Ave. #202 Phone: (626) Hacienda Heights Jennifer Chang, DDS 1850 S Azusa Avenue #202 Phone: (626) Huntington Beach Sebastian Gonzales, DDS Main Street #206 Phone: (714) Laguna Hills Alicia Parkway Dental Alicia Pkwy Suite #1 Phone: (949) Laguna Woods Seven Day Dental Moulton Pkwy. #C1 Phone: (949) Lakewood Lakewood Dental Center 5464 South Street Phone (562) Long Beach Long Beach Family Dental 2006 Long Beach Blvd. #E Phone: (562) Newport Beach Smile Spa Dentistry 496 Old Newport Blvd. #5 Phone: (949) Norwalk Norwalk Plaza Dentistry E. Rosecrans #D Phone: (562) Placentia Daniel Lee, DDS 1061 E. Imperial Hwy. Phone: (714) San Pedro H. Cohen Kheradyar, DDS 138 S. Gaffey Street Phone: (310) Torrance Mylena Ji, DDS Crenshaw Blvd. #201 Phone: (310) Tustin Market Place Dentistry 2925 El Camino Real Phone: (714) Whittier Washington Dental Group E. Washington Blvd. Phone: (562) Los Alamitos Beachwood Dental Reagan Street Phone: (714) Mission Viejo James Vartanian, DDS La Paz Rd. #203 Phone: (949)

13 DHA PANEL PROVIDERS Dental Specialists ENDODONTISTS (ROOT CANALS) Anaheim Seven Day Dental 2261 W. Lincoln Ave. Phone: (714) Brea Darren Smolkin, DDS 503 E. Imperial Highway Phone: (714) Lakewood Mike Bardi, DDS 5830 N. Bellflower Blvd. Phone: (562) Long Beach John Aivaz, DDS 5175 E. Pacific Coast Hwy. #405 Phone: (562) Montebello Mike Bardi, DDS 600 Beverly Blvd. #B Phone: (323) South Gate Central Endodontics 2711 Santa Ana Street Phone: (323) Torrance Mike Bardi, DDS 3663 Torrance Blvd. #3 Phone: (310) Whittier Kwor Loo, DDS 7201 S. Painter Avenue Phone: (562)

14 DHA PANEL PROVIDERS Dental Specialists ORAL SURGEONS Anaheim Michael Blum, DDS 1211 W. La Palma #604 Phone: (714) Anaheim Seven Day Dental 2261 W. Lincoln Ave. Phone: (714) Brea Grant Jong, DDS 503 E. Imperial Hwy Phone: (714) Costa Mesa Rick J. Berrios, DDS 1801 Newport Blvd. #C Phone: (949) Downey Ameet Chopra, DDS Paramount Blvd. #B Phone: (562) Huntington Beach Rick J. Berrios, DDS Main Street #205 Phone: (714) Mission Viejo Junil Ahn, DDS, MD Medical Ctr Rd #238 Phone: (949) Pico Rivera Brennan Hughes, DMD 8337 Telegraph Rd. #219 Phone: (562)

15 DHA PANEL PROVIDERS Dental Specialists PEDODONTISTS (CHILDREN S DENTIST) Anaheim Seven Day Dental 2261 W. Lincoln Ave. Phone: (714) Corona James Richardson, DDS 910 S. Washburn Ave. #B Phone: (951) Downey Michael Vert, DDS Paramount Blvd. #B Phone: (562) Irvine Teddy Bear Dental 3500 Barranca Pkwy. #260 Phone: (949) PERIODONTISTS (GUM TREATMENTS) Anaheim Seven Day Dental 2261 W. Lincoln Ave. Phone: (714) Downey Afshin Salamati, DDS Paramount Blvd. #B Phone: (562) Rancho Santa Margarita Jinous Eslami, DDS Santa Margarita Pkwy. #300 Phone: (949) Lake Forrest Keith Tam, DDS El Toro Rd. #C Phone: (949)

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17 UFCW Local Stanton Avene Buena Park, CA (714) (800) This brochure was printed and mailed at no cost to you or your union by: Dental Health Associates, Inc Laurel Canyon Blvd., Suite 209 North Hollywood, California Telephone (818) January 2019